<%@ page contentType="text/html; charset=utf-8" %>
<form id="editLiverDocForm" onsubmit="return false;">
<table>
<tr>
    <td><label id="patientDoc.docNo_Label">序号</label></td>
    <td><input type="text" name="patientDoc.docNo" value="${patientDoc.docNo }"></td>
	<td><label id="patientDoc.name_Label">姓名</label></td>
    <td><input type="text" name="patientDoc.name" value="${patientDoc.name }"></td>
	<td><label id="patientDoc.sex_Label">性别</label></td>
    <td><input type="text" name="patientDoc.sex" value="${patientDoc.sex }"></td>
</tr>
<tr>
	<td><label id="patientDoc.surveyDay_Label">调查时间</label></td>
    <td><input type="text" name="patientDoc.surveyDay" value="${patientDoc.surveyDay }"></td>
	<td><label id="patientDoc.birthday_Label">出生日期</label></td>
    <td><input type="text" name="patientDoc.birthday" value="${patientDoc.birthday }"></td>
	<td><label id="patientDoc.age_Label">年龄</label></td>
    <td><input type="text" name="patientDoc.age" value="${patientDoc.age }"></td>
</tr>
<tr>
	<td><label id="patientDoc.marriy_Label">婚况</label></td>
    <td><input type="text" name="patientDoc.marriy" value="${patientDoc.marriy }"></td>
	<td><label id="patientDoc.job_Label">职业</label></td>
    <td><input type="text" name="patientDoc.job" value="${patientDoc.job }"></td>
	<td><label id="patientDoc.jobName_Label">职业2</label></td>
    <td><input type="text" name="patientDoc.jobName" value="${patientDoc.jobName }"></td>
</tr>
<tr>
	<td><label id="patientDoc.nation_Label">民族</label></td>
    <td><input type="text" name="patientDoc.nation" value="${patientDoc.nation }"></td>
	<td><label id="patientDoc.nationality_Label">民族2</label></td>
    <td><input type="text" name="patientDoc.nationality" value="${patientDoc.nationality }"></td>
	<td><label id="patientDoc.disCourse_Label">病程</label></td>
    <td><input type="text" name="patientDoc.disCourse" value="${patientDoc.disCourse }"></td>
</tr>
<tr>
	<td><label id="patientDoc.stature_Label">身高</label></td>
    <td><input type="text" name="patientDoc.stature" value="${patientDoc.stature }"></td>
	<td><label id="patientDoc.weight_Label">体重</label></td>
    <td><input type="text" name="patientDoc.weight" value="${patientDoc.weight }"></td>
	<td><label id="patientDoc.bloodType_Label">体重</label></td>
    <td><input type="text" name="patientDoc.bloodType" value="${patientDoc.bloodType }"></td>
</tr>
<tr>
	<td><label id="patientDoc.disSource_Label">病人来源</label></td>
    <td><input type="text" name="patientDoc.disSource" value="${patientDoc.disSource }"></td>
	<td><label id="patientDoc.disSourceNo_Label">住院号</label></td>
    <td><input type="text" name="patientDoc.disSourceNo" value="${patientDoc.disSourceNo }"></td>
	<td><label id="patientDoc.homeAddress_Label">家庭住址</label></td>
    <td><input type="text" name="patientDoc.homeAddress" value="${patientDoc.homeAddress }"></td>
</tr>
<tr>
	<td><label id="patientDoc.homePhone_Label">住宅电话</label></td>
    <td><input type="text" name="patientDoc.homePhone" value="${patientDoc.homePhone }"></td>
	<td><label id="patientDoc.inputDate_Label">录入时间</label></td>
    <td><input type="text" name="patientDoc.inputDate" value="${patientDoc.inputDate }"></td>
	<td><label id="patientDoc.inputUserName_Label">录入人</label></td>
    <td><input type="text" name="patientDoc.inputUserName" value="${patientDoc.inputUserName }"></td>
</tr>
</table>
</form>
